Medicare (CMS) Edits

OCExaminer analyzes your claims based on the OPPS regulations from CMS. This includes outpatient Medicare claims having bill types of 12x, 13x or 14x.

Edit Reference Information is provided when available and multiple issues per line and per claim are also provided.

CMS provides quarterly updates to their outpatient code editor. OCExaminer is maintained to reflect the most up-to-date requirements from CMS and is version-based, so claims for services provided historically can be analyzed against relevant guidelines and regulations.